Improving access to community-based mental health care and psychosocial support within a disaster context

Budosan, Boris; O'Hanlon, Katherine P.; Aziz, Sabah

doi:10.4161/dish.27805

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…However, the recruitment and retention of practitioners sufficiently skilled to deliver MHPSS programmes continues to be an ongoing challenge, especially in resource-limited settings where there may be a lack of incentives to work in the mental health sector (Eisenbruch et al 2004; Budosan & Aziz, 2009; Budosan & Bruno, 2011). These findings underscore the need to explore the potential of different training approaches such as the ‘apprenticeship model’ and ‘training of trainers’ to ascertain if they can support organisations to develop and retain practitioners at the level of skill and numbers required to ensure programme fidelity and reach (Murray et al 2011; Quosh, 2013; Budosan et al 2014; Henderson et al 2016).…”

Section: Discussionmentioning

confidence: 99%

What are the barriers to, and facilitators of, implementing and receiving MHPSS programmes delivered to populations affected by humanitarian emergencies? A qualitative evidence synthesis

Dickson

Bangpan

2018

Glob. Ment. Health

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Background.Humanitarian emergencies can impact people's psychosocial well-being and mental health. Providing mental health and psychosocial support (MHPSS) is an essential component of humanitarian aid responses. However, factors influencing the delivery MHPSS programmes have yet to be synthesised. We undertook a systematic review on the barriers to, and facilitators of, implementing and receiving MHPSS programmes delivered to populations affected by humanitarian emergencies in low- and middle-income countries.Methods.A comprehensive search of 12 bibliographic databases, 25 websites and citation checking was undertaken. Studies published in English from 1980 onwards were included if they contained evidence on the perspectives of adults or children who had engaged in or programmes providers involved in delivering, MHPSS programmes in humanitarian settings. Thirteen studies were critically appraised and analysed thematically.Results.Community engagement was a key mechanism to support the successful implementation and uptake of MHPSS programmes. Establishing good relationships with parents may also be important when there is a need to communicate the value of children and young people's participation in programmes. Sufficient numbers of trained providers were essential in ensuring a range of MHPSS programmes were delivered as planned but could be challenging in resource-limited settings. Programmes need to be socially and culturally meaningful to ensure they remain appealing. Recipients also valued engagement with peers in group-based programmes and trusting and supportive relationships with providers.Conclusion.The synthesis identified important factors that could improve MHPSS programme reach and appeal. Taking these factors into consideration could support future MHPSS programmes achieve their intended aims.

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Section: Discussionmentioning

confidence: 99%

What are the barriers to, and facilitators of, implementing and receiving MHPSS programmes delivered to populations affected by humanitarian emergencies? A qualitative evidence synthesis

Dickson

Bangpan

2018

Glob. Ment. Health

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“…In less than fi ve years, the mhGAP approach has created great interest within low-and middle-income countries. Ministries of health and non-governmental organizations alike have adopted and adapted the materials and used them in over 50 countries (Abdulmalik et al, 2013;Abera et al, 2014;Budosan et al, 2014;Hijazi et al, 2011;Rose et al, 2011).…”

Section: Mhgap: Revitalizing Primary Mental Healthcarementioning

confidence: 99%

Integration of mental health into primary healthcare in low-income countries: Avoiding medicalization

Ventevogel

2014

International Review of Psychiatry

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Since 2008 the World Health Organization (WHO), through its mental health Gap Action Programme, has attempted to revitalize efforts to integrate mental health into non-specialized (e.g. primary) healthcare. While this has led to renewed interest in this potential method of mental health service delivery, it has also prompted criticism. Some concerns raised are that it would contribute to the medicalization of social and psychological problems, and narrowly focus on primary care without sufficient attention given to strengthening other levels of the healthcare system, notably community-based care and care on district levels. This paper discusses seven elements that may be critical to preventing inadvertently contributing to increasing a narrow biomedical approach to mental healthcare when integrating mental health into non-specialized healthcare: (1) using task shifting approaches within a system of stepped care, (2) ensuring primary mental healthcare also includes brief psychotherapeutic interventions, (3) promote community-based recovery-oriented interventions for people with disabling chronic mental disorders, (4) conceptualizing training as a continuous process of strengthening clinical competencies through supervision, (5) engaging communities as partners in psychosocial interventions, (6) embedding shifts to primary mental healthcare within wider health policy reforms, and (7) promoting inter-sectoral approaches to address social determinants of mental health.

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“…Interventions in other countries post-disasters (Mahoney et al, 2006;Jones et al, 2007;Budosan et al, 2008;Ventevogel et al, 2012;Budosan et al, 2014) improved somewhat the systems of mental health services quickly after the disaster, those interventions were less comprehensive than the Philippine program in the first year after disaster. Prior efforts have established such components as a sustainable system of distribution, prescription and use of psychotropic medications; and an increase in local hospital capacity for admission of acute psychiatric patients only later after disaster.…”

Section: Discussionmentioning

confidence: 99%

“…In Aceh, an area in Indonesia hardest hit by 2004 Tsunami, 483 people received mental health services in the first year after the disaster thanks to the joint effort of INGO International Medical Corps (IMC) and the Ministry of Health (MoH) to build local capacity at the primary healthcare (PHC) level . In Haiti, after the 2010 earthquake, 190 community-level workers and 115 non-specialized healthcare providers were trained and 616 mental health consultations were provided by INGO Cordaid in cooperation with local NGO partners (Budosan et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Up scaling mental health and psychosocial services in a disaster context: Lessons learnt from the Philippine Region hardest hit by typhoon Haiyan

Budosan¹,

Oâ€TMHanlon²,

Mahoney³

et al. 2016

Int. J. Med. Med. Sci.

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In the aftermath of typhoon Haiyan which struck Philippines in 2013, the World Health Organization Philippines in collaboration with the Philippine government acted to improve access to mental healthcare in affected regions. Eastern Visayas with population 4, 3 million had merely four psychiatrists and seven generalists providing mental health care. It was selected as a model region for integration of mental health care into primary and secondary care. This study was carried out to evaluate the intervention's success in strengthening mental health services in Eastern Visayas with particular regard to availability, accessibility and affordability of these services. Between June 2014 and March 2015, 1038 community workers were trained in psychosocial care and support and 290 nonspecialized healthcare providers received training on assessment and management of mental health conditions including on-the-job supervision. By the end of the March 2015, 155 of 159 or 97.5% of primary healthcare units, 21 of 24 District Hospitals (87, 5%) and all eight provincial hospitals had a doctor and a nurse trained in assessment and management of mental health conditions. The supervised sessions in each locale benefited 50 to 200 patients per location. Regional Medical Centre added a 10 bed inpatient unit for the mentally ill. All provincial hospitals developed the capacity to admit 2 to 4 patients for acute psychiatric care and additional capacity was established in at least 6 district hospitals. In addition, services were enhanced to include access to and use of psychotropic medicines, cross-sectoral collaboration and a clinical referral pathway from the community to the tertiary level. This study demonstrates the feasibility of an intervention in a resource poor context, post-disaster, to improve access to mental healthcare care services over a relatively short period of time.

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Improving access to community-based mental health care and psychosocial support within a disaster context

Cited by 8 publications

References 13 publications

What are the barriers to, and facilitators of, implementing and receiving MHPSS programmes delivered to populations affected by humanitarian emergencies? A qualitative evidence synthesis

What are the barriers to, and facilitators of, implementing and receiving MHPSS programmes delivered to populations affected by humanitarian emergencies? A qualitative evidence synthesis

Integration of mental health into primary healthcare in low-income countries: Avoiding medicalization

Up scaling mental health and psychosocial services in a disaster context: Lessons learnt from the Philippine Region hardest hit by typhoon Haiyan

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